Prospective study of talc use and ovarian cancer

Background: Perineal talc use has been associated with an increased risk of ovarian cancer in a number of case-control studies; however, this associat ion remains controversial because of limited supporting biologic evidence a nd the potential for recall bias or selection bias in case-control studies. In this study, we conducted a prospective analysis of perineal talc use an d the risk of ovarian cancer. Methods: The Nurses' Health Study is a prospe ctive study of 121 700 female registered nurses in the United States who we re aged 30-55 Sears at enrollment in 1976. Talc use was ascertained in 1982 by use of a self-administered questionnaire: after exclusions, 78 630 wome n formed the cohort for analysis. Three hundred seven epithelial ovarian ca ncers subsequently diagnosed in this cohort through June 1, 1996, were conf irmed by medical-record review and met inclusion criteria. Proportional haz ards models by use of pooled logistic regression were used to derive relati ve risks (RRs) and 95% confidence intervals (CIs), Results:: In 1982, 40.4% (n = 31 789) of the cohort reported ever using talc, and 14.5% (n = 11 411 ) reported ever using talc daily. We observed no overall association with e ver talc use and epithelial ovarian cancer (multivariate RR = 1.09; 95% CI 0.86-1.37) and no increase in risk of ovarian cancer with increasing freque ncy of use. There was a modest elevation in risk for ever talc use and inva sive serous ovarian cancer (multivariate RR = 1.40; 95% CI = 1.02-1.91), Th e risk of epithelial ovarian cancer for talc users was not greater among wo men who had never had a tubal ligation (multivariate RR = 0.97; 95% CI = 0. 71-1.32). Conclusion: Our results provide little support for any substantia l association between perineal talc use and ovarian cancer risk overall; ho wever, perineal talc use may modestly increase the risk of invasive serous ovarian cancer.